Şizofrenide Şiddet

Pek çok psikiyatrik hasta şiddet eğilimi sergilememekte ise de günümüz toplumunda ruhsal bozukluk ve şiddet biribiyle bağlantılı görülmektedir. Genel populasyon ile kıyaslandığında şiddet davranışı riski şizofrenide istatistiksel olarak anlamlı bir yükseklik göstermiştir. Şizofrenide şiddet davranışı riski madde kullanım eştanılılığı ile artmaktadır. Şizofreni tanılı yetişkinlerde şiddet davranışının ortaya çıkması, antisosyal kişilk bozukluğu ve şizofreninin akut psikopatolojisi ile ilişkili iki farklı yol izlemektedir. Klozapin şizofrenide şiddet davranışı tedavisinde en etkin tedavidir. Son kanıtlar olanzapini ikinci sıraya yerleştirmiştir. Tedavi uyumu son derece önemlidir. Farmakolojik olmayan tedavi yöntemleri giderek artmaktadır. Tek başına farmakoterapinin yetersiz kaldığı olgularda, bireysel davranışçı yöntemler etkili olmaktadır.

Violence in Schizophrenia

Although most psychiatric patients are not violent, serious mental illness is associated with increased risk of violent behavior. There was statistically significant increase of risk of violence in schizophrenia in comparison with general population. The risk of violence in schizophrenia is increased by comorbid substance use disorder. Violence among adults with schizophrenia may follow at least two distinct pathways one associated with antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Clozapine is the most effective treatment of violence behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second line of treatment. Treatment adherence is of key importance. Non-pharmacological methods of treatment of violence in schizophrenia are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone does not suffice.

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